目的 探讨慢性咳嗽与阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)之间的关系。方法 对21例确诊为慢性咳嗽的患者,院外给予相关治疗后,咳嗽症状未见改善,入院后经标准多导联睡眠图(polysomnography, PSG)诊断为OSAHS,通过经鼻持续气道正压呼吸(continuous positive airway pressure,CPAP)治疗,评价治疗前后,慢性咳嗽症状变化情况。结果 经CPAP治疗后,慢性咳嗽患者咳嗽均有不同程度的改善,其中16例咳嗽症状好转,5例痊愈。结论 慢性咳嗽与OSAHS之间具有一定的相关性。
Abstract
Objective To explore the correlations between obstructive sleep apnea hypopnea syndrome(OSAHS)and chronic cough.Methods Twenty-one cases of patients with chronic cough who had been diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association received relevant treatment away from a hospital. However,their symptoms did not seem improved. Then, they were diagnosed with OSAHS via polysomnography(PSG) and hospitalized.They were treated with continuous positive airway pressure(CPAP).Results These patients with chronic cough improved to different extents after CPAP therapy and five of them even recovered.Conclusions Chronic cough and OSAHS have some correlations.
关键词
慢性咳嗽 /
阻塞性睡眠呼吸暂停综合征 /
相关性
Key words
chronic cough /
obstructive sleep apnea hypopnea syndrome /
correlation
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参考文献
[1] 陈灏珠,林果为,王吉耀.实用内科学[M].14版.北京:人民卫生出版社,2015:1687-1690.
[2] Chung K F,Pavord I D.Prevalence,pathogenesis,and causes of chroniccough[J]. Lancet,2008,371(9621):1364-1374.
[3] Morice A.Chroniccough:epidemiology[J].ChronRespir Dis,2008,5(1):43-47.
[4] McGarvey L P.Idiopathic chronic cough: a real disease or a failure ofdiagnosis?[J].Cough,2005,1(1):9.
[5] 王长征,张 巧.慢性咳嗽:诊治流程及治疗新进展[J].解放军医学杂志,2014,39(5):358-360.
[6] Chandra K M,Harding S M.Therapy insight:treatment of gastroesophageal reflux in adults with chonic cough[J].Nat Clin Pract Gastroenterol Hepatol,2007,4(11):604-613.
[7] Durzo A,Jugovic P.Chronic cough:Three most common causes[J].Can Fam Physician,2002,48(1):1311-1316.
[8] 李 丽,杨瑞虹,刘红丹.慢性咳嗽117例病因误诊分析[J].临床误诊误治,2015,28(10):42-45.
[9] Sundar K M,Daly S E,Pearce M J,et al.Chroniccough and obstructive sleep apnea in a community-based pulmonary practice[J].Cough,2010,6(1):2.
[10] Sundar K M,Daly S E,Willis A M.A longitudinal study ofCPAP therapy for chronic cough patients with obstructive sleepapnoea[J].Cough,2013,9(1):19.
[11] Chan K K Y,Ing A J,Laks L,et al.Chronic cough in patients with sleep-disordered breathing[J].EurRespir J,2010,35(2):368-372.
[12] 范昭宾,朱文澍,王 瑞,等.煤矿工人吸烟与粉尘暴露对肺通气功能的影响[J].中国工业医学杂志,2008,21(1):17-19.
[13] Sundar K M,Daly S E.Chronic cough and OSA: a newassociation?[J].J Clin Sleep Med,2011,7(6):669-677.
[14] Kuribiyashi S,Massey B T,Hafeezullah M,et al.Upperesophageal sphincter and gastroesophageal junction pressurechanges act to prevent gastroesophageal and esophagophar-yngealreflux during apneic episodes with obstructive sleep apnea[J]. Chest,2010,137(4):769-776.
[15] Eastwood P R,Katagiri S,Shepherd K L,et al.Modulation of upper and lower esophageal sphincter tone duringsleep[J].Sleep Med,2007,8(2):135-143.
[16] Kahrilas P J.Obstructive sleep apnea and reflux disease:bedfellows at best[J]. Chest,2010,137(4):747-748.
[17] Faruqi S,Fahim A,Morice A H.Chronic cough andobstructive sleep apnoea: reflux-associated cough hypersensitivity?[J].EurRespir J,2012,40(4):1049-1050.
[18] Sundar K M,Daly S E.Chronic Cough and OSA: An Underappreciated Relationship[J].Lung,2014,192(1):21-25.
[19] Carpagnano G E,Spanevello A,Sabato R, et al.ExhaledpH,exhalednitricoxide,and induced sputum cellularity in obese patients withobstructive sleep apnea syndrome[J].Trans Res,2008,151(1):45-50.
[20] Sariman N,Levent E,Cubuk R, et al.Bronchialhyperreactivity and airway wall thickening inobstructive sleep apnea patients[J].Sleep Breath,2011, 15(3):341-350.
[21] 杨叶叶,刘剑波.慢性咳嗽与阻塞性睡眠呼吸暂停低通气综合征的关系研究[J].医药论坛杂志,2014,32(2):96-97.
[22] Shepherd K L,Holloway R H,Hillman D R,et al.The impact of continuous positive airway pressure on the loweresophageal sphincter [J].Am J PhysiolGastrointest LiverPhysiol,2007,292(5):G1200-G1205.
[23] Korczynski P,Gorska K,Przybylowski T,et al.Continuous positive airway pressure treatmentincreasesbronchial reactivity in obstructive sleep apnea patients[J].Respiration,2009,78(4): 404-410.
[24] Ciftci T U,Ciftci B,Guven S F,etal.Effect of nasal continuous positive airway pressure in uncontrolled nocturnalasthmatic patients with obstructive sleep apnea syndrome[J].Respir Med,2005,99(5):529-534.
[25] Koustsourelakis I, Vagiakis E, Perraki E, et al.Nasal inflammation in sleep apnoeapatients using CPAP and effect of heated humidification A randomized,shamcontrolled, cross-over study[J].EurRespir J,2011,37(3):587-594.
[26] Arias M A, Garcia-Rio F, Alonso-Fernandez A, et al.CPAP decreases plasmalevels of soluble tumournecrosis factor-alpha receptor inobstructive sleepapnoea[J]. EurRespir J,2008,32(4):1009-1015.
[27] Tamaki S,Yamauchi M,Fukuoka A,etal.Production of inflammatory mediatorsby monocytes in patients with obstructive sleep apnea syndrome[J].Intern Med,2009,48(15):1255-1262.
[28] Steiropoulos P,Kotsianidis I,Nena E,et al.Long term effect of continuous positiveairway pressure therapy on inflammation markers on patients with obstructivesleep apnea syndrome[J].Sleep,2009,32(4):537-543.
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